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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 28, 2021; 9(1): 12-28
Published online Feb 28, 2021. doi: 10.13105/wjma.v9.i1.12
Exosomes: A new frontier under the spotlight for diagnosis and treatment of gastrointestinal diseases
Maliha Naseer, Syeda Hadi, Ali Syed, Amer Safdari, Veysel Tahan
Maliha Naseer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, East Carolina University, Greenville, NC 27834, United States
Syeda Hadi, Rawalpindi Medical University, School of Medicine, Rawalpindi 46000, Punjab, Pakistan
Ali Syed, Veysel Tahan, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
Amer Safdari, Illinois College of Medicine, School of Medicine, Chicago, IL 60612, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maliha Naseer, MD, Academic Fellow, Division of Gastroenterology and Hepatology, Department of Internal Medicine, East Carolina University, 521 Moye Blvd, Greenville, NC 27834, United States. naseerm18@ecu.edu
Received: October 21, 2020
Peer-review started: October 21, 2020
First decision: November 3, 2020
Revised: December 15, 2020
Accepted: February 22, 2021
Article in press: February 22, 2021
Published online: February 28, 2021
Processing time: 131 Days and 17.2 Hours
Abstract

Exosomes are small plasma membrane-bound multivesicular bodies ranging in size from 20-100 nm. Exosomes are degraded fragments of mRNA, microRNA, and enriched in proteins, lipids, and nucleic acid. They are produced in the endosomes of most eukaryotic cells and once secreted, exosomes are involved in cell to cell communication and remodeling of the matrix in the extracellular compartment. Exosome biogenesis plays a crucial role in cellular development, inflammation, immunity, hemostasis, carcinogenesis, and degeneration. Due to their unique biochemical and biophysical properties, exosomes serve a variety of functions including biomarkers of diagnostic and prognostic significance. Besides, there is an increasing level of evidence to expand our understanding of the exosomes as novel therapeutic agents. Inflammatory bowel disease (IBD) such as Crohn's disease and ulcerative colitis, hepatic fibrosis, and gastrointestinal malignancies such as colorectal cancer are the potential avenues where exosomes can be applied as cell therapy and immunotherapy and have shown promising results in several in-vitro and animal models. The purpose of this review article is to highlight the emerging role of exosomes as the diagnostic and therapeutic tool in various diseases involving the gastrointestinal tract like IBD, hepatocellular carcinoma, and colon cancer. A thorough literature search was performed on databases such as PubMed, Ovid Medline, and EMBASE to achieve the objectives of this review article.

Keywords: Exosomes; Gastrointestinal diseases; Inflammatory bowel disease; Colorectal cancer; Hepatocellular carcinoma

Core Tip: Exosomes are tiny membrane-bound extracellular vesicles that are becoming increasingly popular due to their potential role in regulating various intracellular and extracellular signaling pathways. Exosome biogenesis has been shown to plays a role in cellular development, inflammation, immunity, hemostasis, carcinogenesis, and degeneration. Due to their unique properties, exosomes have the potential to serve as diagnostic, prognostic, and therapeutic vectors. This review provides a concise summary of the role of exosomes as the diagnostic and therapeutic tool in various diseases involving the gastrointestinal tract.